Association of dietary choline intake in late pregnancy with the early neurobehavioral development of offspring

Abstract

Objective: To investigate the level of dietary choline intake among pregnant women during late pregnancy and its association with the early neurobehavioral development of their offspring.

Methods: This study was a prospective cohort study. Convenience sampling was employed to recruit pregnant women hospitalized in the Obstetrics Department of the Affiliated Maternity and Child Health Care Hospital of Nantong University from November 2023 to December 2024. The semi-quantitative Food Frequency Questionnaire (FFQ) was used to assess dietary choline intake and other nutrient intakes among pregnant women during late pregnancy. The infants were evaluated at 1, 3 and 6 months of age using the Bayley Scales of Infant and Toddler Development Revised in Chinese Cities (BSID-CR). In addition, the potential relationship between maternal dietary choline intake and infants' intelligence score, motor score, Mental Development Index (MDI), and Psychomotor Development Index (PDI) were analyzed by generalized estimating equations.

Results: A total of 256 mother-infant pairs were included in the analysis. Maternal dietary choline intake during late pregnancy was 343.35 (332.20, 354.73) mg/d, with only 1.56% of the pregnant women meeting the Adequate Intake (AI). Mothers and infants were categorized into four groups (Q1 to Q4) based on the quartiles of energy-adjusted dietary choline intake, ranging from low to high. Generalized estimating equations indicated that the four groups exhibited statistically significant differences in the changes in infants' intelligence scores (Waldχ² = 12.842, P = 0.005), motor scores (Waldχ² = 8.981, P = 0.030), MDI (Waldχ² = 13.447, P = 0.004), and PDI (Waldχ² = 12.209, P = 0.007). After adjustment for confounding factors, the four groups showed statistically significant differences in the changes in intelligence scores (Waldχ² = 11.873, P = 0.008), MDI (Waldχ² = 11.710, P = 0.008), and PDI (Waldχ² = 10.318, P = 0.016), while no significant differences were found in the changes in motor scores (Waldχ² = 6.609, P = 0.085).

Conclusions: Maternal dietary choline intake was significantly associated with intelligence scores, MDI and PDI in infants. Additionally, the dietary choline intake of pregnant women in late pregnancy was notably insufficient. It is recommended that medical staff should pay attention to the choline intake of pregnant women and develop nutrient intervention programs to enhance the health of both mothers and infants. However, no causal inferences can be made from this study.

Keywords: Choline; Infant; Late pregnancy; Neurobehavioral development.